Codeine is an opioid used to alleviate mild-to-moderate pain and treat cough. Like morphine and thebaine, it is an opium alkaloid that can also be used to produce semi-synthetic opioids. Although codeine is relatively weak and can be found in cough syrups, it isn’t any safer than other drugs in the opioid family.
This article will answer the most popular questions about codeine, including:
- What is codeine?
- What is codeine used for, and how does it affect your body?
- What is codeine abuse, and what are the risks associated with it?
- What is codeine addiction, and how does it differ from codeine dependence?
Without further ado, let’s get straight to it!
What Is Codeine, and What Is It Used For?
Codeine is an opioid drug commonly prescribed to manage mild-to-moderate pain that cannot be treated with non-opioid pain relievers. It can also be used to suppress cough.
As a natural opioid—or opiate—codeine is derived directly from the opium poppy plant. It is available as a tablet, injection, or oral liquid in both immediate- and extended-release formulations.
Although pure codeine is considered the weakest opioid, it is classified as a Schedule II controlled substance due to its high potential for abuse, dependence, and addiction. It can be synthesized to produce more potent opioid medications, such as hydrocodone and dihydrocodeine.
Codeine is also an active ingredient in several combination medications, such as:
- Codeine/acetaminophen (Tylenol® #3 and #4, Panadeine Forte®, Vopac®)
- Codeine/ibuprofen (Solpadeine®, Nurofen® Plus)
- Codeine/aspirin (Aspalgin®)
Since codeine is less regulated and easier to obtain than other opioids, it is a popular street drug. Captain Cody, Schoolboy, Syrup, Cody, and Purple Drank are some of its most common street names. The latter refers to a polysubstance drink—also known as Lean and Sizzurp—that contains a mixture of codeine cough syrup and soda, alcohol, or other substances.
Now that you know what codeine is, let’s find out how it affects your body.
How Does Codeine Affect Your Body?
Codeine, which is converted into morphine once consumed, affects the body by attaching to opioid receptors, thereby stopping pain signals from reaching the brain.
Its pain-relieving effects kick in within 30 minutes following administration and last for around four hours. However, around 5–10% of people do not feel pain relief after taking this medication due to genetic factors that inhibit the metabolization of codeine into morphine.
Codeine’s effects are very similar to those of other opioids, albeit weaker. Besides pain relief, it can also induce feelings of euphoria and relaxation, enhancing the risk of opioid abuse.
Moreover, codeine is thought to decrease activity in the part of the brain controlling coughing. However, a study by researchers from the University of Wales suggests that codeine is ineffective in reducing cough, even though it is often prescribed as an antitussive. Given that it is also habit-forming, it’s best to seek other non-opioid cough remedies.
Side Effects of Using Codeine
Codeine can cause various side effects, with the most common of them being:
- Itching
- Fatigue
- Nausea
- Vomiting
- Headache
- Dry mouth
- Blurry vision
- Stomach pain
- Muscle stiffness
- Trouble urinating
- Lightheadedness
- Reduced appetite
- Difficulty breathing
- Changes in blood pressure and heart rate
If you experience any side effects while using codeine, consult with your doctor. Some side effects, including allergic reactions, may require immediate medical attention.
Although there’s a lack of data on codeine and seizures, researchers from National Cheng Kung University found that higher doses of codeine may cause seizures in elderly patients with end-stage renal disease.
To reduce the risk of codeine side effects, always take your medication as prescribed. Do not mix it with any substances your doctor hasn’t approved of.
Combining codeine with substances that raise serotonin levels is particularly dangerous due to an increased risk of serotonin syndrome. This life-threatening condition is characterized by:
- Fever
- Nausea
- Vomiting
- Diarrhea
- Agitation
- Shivering
- Confusion
- Stiff muscles
- Difficulty speaking
- Twitching muscles
- Trouble swallowing
- Excessive sweating
- Elevated blood pressure
Long-Term Effects of Codeine
Long-term codeine use increases the risk of:
- Tolerance
- Liver injury
- Dependence
- Kidney damage
- Opioid overdose
- Respiratory depression
Taking codeine for an extended time also exposes you to the risk of opioid use disorder (OUD), commonly known as opioid addiction.
On that note, let’s find out what codeine dependence and addiction are.
Codeine Addiction vs. Codeine Dependence
Codeine addiction isn’t the same as codeine dependence. Nonetheless, these terms are often used interchangeably, and it’s not uncommon for these conditions to co-occur.
Codeine dependence refers to the physical dependence that anyone taking this drug for a prolonged time can develop. It is characterized by two main symptoms:
- Tolerance. Repeated opioid exposure causes the brain to stop producing natural endorphins and create more opioid receptors, leading to tolerance. Tolerance can build up very quickly, and once this happens, your body will require more codeine to achieve the same effects as before.
- Opioid withdrawal symptoms. People dependent on codeine rely on it to function normally, as not taking the drug triggers withdrawal symptoms, such as cravings, insomnia, and body aches. These symptoms can be very uncomfortable; many people continue taking codeine just to avoid them.
If left untreated, codeine dependence can turn into an addiction, which is primarily psychological. Those struggling with prescription drug addiction cannot control their impulses. As such, people addicted to codeine can’t stop taking it, even when it negatively affects their lives.
Now that we’ve discussed what codeine dependence and addiction are, it’s time to learn more about codeine withdrawal symptoms.
Codeine Withdrawal Symptoms
Codeine withdrawal symptoms occur when people quit taking codeine or decrease their dosage after becoming dependent.
Withdrawal symptoms from codeine typically set in within 24 hours after the last dose and last around two weeks. However, the timeline of codeine withdrawal largely depends on the drug’s formulation and other factors, such as the extent of codeine use. Abrupt drug discontinuation can increase both the severity and the duration of codeine withdrawal symptoms.
The most common codeine withdrawal symptoms are:
- Chills
- Fever
- Anxiety
- Diarrhea
- Headache
- Depression
- Runny nose
- Watery eyes
- Enlarged pupils
- Codeine cravings
- Increased sweating
- Abdominal cramping
- Bone and joint aches
- Nausea and vomiting
Some of these symptoms may lead to life-threatening complications, such as dehydration. Moreover, going through codeine withdrawal puts you at a high risk of relapse, which can result in a potentially fatal overdose due to decreased tolerance. Because of this, it’s in your best interest to seek professional opioid addiction treatment once you decide to quit codeine.
Codeine Abuse and Overdose
Codeine abuse refers to any type of drug use that has not been prescribed by a doctor. In other words, if you use illicitly obtained codeine, take it for non-medical purposes, or use it in any other way than prescribed, you’re abusing the drug. This significantly increases the risk of codeine dependence, addiction, and overdose.
Here are some common ways in which people abuse codeine:
- Using codeine without a prescription
- Crushing and snorting or injecting codeine tablets
- Taking codeine in larger doses or more frequently than prescribed
- Combining codeine with other substances without the doctor’s approval
Codeine cough syrup abuse has become widespread in recent years; most commonly, people mix it with alcohol and soda to enhance its effects.
Codeine addiction often starts with codeine cough syrup abuse and eventually leads to the use and abuse of more potent opioids, such as oxycodone. Therefore, even though codeine may seem relatively harmless compared to opioids, it wouldn’t be an overstatement to call it a gateway drug.
Most importantly, codeine abuse dramatically increases the risk of codeine overdose, which happens when you ingest a larger amount of the drug than your body can safely metabolize. If not treated on time, it can be fatal.
Since you’re now aware of the answer to the question “What is codeine abuse, and what are the dangers associated with it?”, let’s dive deeper into the risks of mixing codeine with other drugs.
Mixing Codeine With Other Drugs
Mixing codeine with other drugs—be they alcohol, illicit drugs, or prescription medications—constitutes codeine abuse.
Due to the high risk of dangerous drug interactions, codeine side effects, overdose, and other adverse effects, you should never mix codeine with any other substance without your doctor’s approval. If you are taking any medications or herbal supplements, inform your doctor about them before initiating codeine therapy.
Some drugs you should never mix with codeine include:
- Alcohol
- Other opioids
- Antipsychotics
- Antihistamines
- Antidepressants
- Muscle relaxants
- Benzodiazepines
Mixing codeine with any of these substances increases the risk of overdose. Meanwhile, taking codeine with alcohol, opioids, and other central nervous system (CNS) depressants can lead to respiratory depression.
To minimize the risk of serotonin syndrome, never mix codeine with antidepressants and other serotonergic drugs. Certain antibiotics (e.g., linezolid) and herbal supplements, such as St. John’s wort, ginseng, and nutmeg, can also induce serotonin syndrome when taken with codeine.
How to Store and Safely Dispose of Codeine
Properly storing and safely disposing of codeine is vital in ensuring your and your loved one’s safety. Even though codeine is relatively weak compared to other opioids, it can cause an overdose—especially if it ends up in the wrong hands.
Here’s how to properly store codeine:
- Keep your medication in its original container. Do not remove the label, as it includes the expiry date, directions, and other important information.
- Pick a secure location. Store codeine in a place that is not accessible by children, pets, or anyone who could misuse it, including guests.
- Avoid heat and moisture. Heat and moisture can damage codeine, so it should be stored at room temperature and away from direct sunlight. Do not store codeine in humid places, such as the bathroom.
If you have any expired, unused, or unneeded codeine medications, you can safely dispose of them through drug take-back programs. If these aren’t available in your location, read the label or check the patient information leaflet to find out how to dispose of codeine safely, as this may depend on the specific product you use.
ANR Opioid Dependence Treatment
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By tackling the root causes of opioid dependence, ANR surpasses other treatments in terms of safety and effectiveness. It restores the brain to its pre-addiction state by re-regulating the endorphin-receptor imbalance, eliminating cravings and other withdrawal symptoms. Due to negating the risk of relapse, the ANR treatment has a very high success rate.
Since ANR is tailored to each patient individually, it is very safe, even for those with underlying medical issues. Moreover, it is only carried out by highly experienced and compassionate board-certified healthcare professionals in an ICU setting of accredited hospitals. The procedure lasts 4–6 hours, whereas the average hospital stay for our patients is only 36 hours.
To get started with ANR, contact us for a free consultation—we’ll be happy to answer your questions and guide you through your recovery!
Key Takeaways
The answer to “What is codeine?” is quite straightforward—it’s an opiate prescribed for mild-to-moderate pain relief. However, even though it is less potent than other medications that act on opioid receptors, you shouldn’t underestimate the risks associated with it.
Lastly, let’s reiterate the key points we covered today:
- Codeine relieves pain by interacting with opioid receptors, but it can also induce euphoria, increasing its potential for abuse, dependence, and addiction.
- Some common side effects of codeine include nausea, vomiting, constipation, blurred vision, and stomach ache.
- If you or someone you love is struggling with codeine dependence, ANR can help you overcome it safely and effectively within a matter of days.
What Is Codeine FAQ
Codeine is addictive, even though it is weaker than other opioids. Nonetheless, repeated codeine use alters brain chemistry, meaning anyone who takes it for a prolonged time can become dependent on and addicted to it.
The greatest risks of taking codeine are opioid abuse, dependence, addiction, and overdose, which can be deadly if not treated promptly. Codeine can also cause various side effects, ranging from nausea to respiratory depression, especially when mixed with other drugs or abused in other ways.
There are many alternatives to codeine, such as acetaminophen, NSAIDs, and topical analgesics. Your doctor can help you determine the best treatment for your needs and medical condition. Keep in mind that some other pain medications can be addictive, too.
While you can use codeine if you have a cough, its antitussive effects are debatable. Since the risks of taking this opioid often outweigh the benefits, it’s in your best interest to explore alternative treatment options. After all, even codeine cough syrup can be habit-forming.
Codeine is a depressant, which means it slows down the functioning of the CNS. Because of this, you may feel drowsy after taking it. You should never mix codeine with other drugs that depress the CNS, such as benzodiazepines, as this can have fatal consequences.